Infections in patients with cystic fibrosis following lung transplantation

BACKGROUND: There is controversy over whether colonization with drug-resistant organisms is a contraindication to lung transplantation. METHODS: We undertook a retrospective review of the results of lung transplantation for patients with cystic fibrosis (CF) at Duke University Medical Center. RESULTS: As of May 1996, 21 patients with CF underwent bilateral lung transplantation. The first patient died within 24 h of transplantation from sepsis due to Stenotrophomonas maltophilia. Of the remaining 20 patients, 17 (85%) are alive and in stable condition. The three deaths were related primarily to bronchiolitis obliterans at 4 and 18 months in two patients and to cytomegalovirus pneumonitis at 5 months in the other patient. The 17 surviving patients have been followed up for a mean of 13 months (range, 0.5 to 34 months). Most of them were colonized and infected with multidrug-resistant organisms before transplantation. Following transplantation, 11 patients had complications from infections. One patient had bacteremia due to a panresistant Burkholderia cepacia and was treated successfully. Two patients had bacteremia and wound infection due to Burkholderia gladioli, previously thought to be pathogenic only in plants. Both patients were treated successfully. Of the six patients with Aspergillus fumigatus isolated from cultures before transplantation, only one had invasive disease following transplantation and responded to treatment. CONCLUSION: The organisms present before transplantation were not the primary cause of mortality in our patient population. Our findings suggest that lung transplantation should be considered in CF patients infected with multidrug-resistant organisms.     

Maximum likelihood estimation of constellation vectors for blindseparation of co-channel BPSK signals and its performance analysis

In this paper, we present a method for blind separation of co-channel BPSK signals arriving at an antenna array. This method consists of two parts: the maximum likelihood constellation estimation and assignment. We show that at high SNR, the maximum likelihood constellation estimation is well approximated by the smallest distance clustering algorithm, which we proposed earlier on heuristic grounds. We observe that both these methods for estimating the constellation vectors perform very well at high SNR and nearly attain Cramer-Rao bounds. Using this fact and noting that the assignment algorithm causes negligible error at high SNR, we derive upper bounds on the probability of bit error for the above method at high SNR. These upper bounds fall very rapidly with increasing SNR, showing that our constellation estimation-assignment approach is very efficient. Simulation results are given to demonstrate the usefulness of the bounds     

Chitosan microcapsules as controlled release systems for insulin

This study analyses the use of chitosan for the production of surface crosslinked microparticulate systems containing insulin. The microcapsules were prepared by an innovative technique based on interfacial crosslinkage of different amounts of chitosan solubilized in the inner phase of a water/oil emulsion by means of ascorbyl palmitate. The correlation between the main formulation parameters and the functional properties of the microcapsules were analysed. Insulin is incorporated with high efficiency. The peptide release is constant for appreciable periods of time. The content of chitosan modulates the main physico-chemical properties of the matrix.     

Comparison of two methods of surfactant administration and the effect on dosing-associated hypoxemia

OBJECTIVE: The purpose of our study was to test the hypothesis that surfactant dosing through a proximal sideport adapter on an endotracheal tube leads to more dosing-associated hypoxemia compared with a method of dosing that uses a double-lumen endotracheal tube. STUDY DESIGN: Using adequate sample size to compare significant changes in O2 saturation (power > 0.8, alpha < 0.05) we enrolled 36 infants with respiratory distress syndrome in this randomized trial. A 10% change in O2 saturation was considered clinically significant. Nineteen infants received 38 doses of surfactant through the sideport adapter. Seventeen infants received 31 doses of surfactant through the nonventilation lumen of a double-lumen endotracheal tube. Two main outcome measures were assessed: time-averaged O2 saturation values 30 minutes after dosing and the largest absolute fall in O2 saturation for each patient. RESULTS AND CONCLUSIONS: Time-averaged O2 saturation measures were higher in the proximal sideport group (p = 0.02), but the magnitude of difference was probably not clinically significant. No significant difference was detected between groups when we compared largest absolute drop in O2 saturation. Secondary analyses found no effect of birth weight or dose number (second vs third dose) on either outcome measure.     

Frequency offset retrodirective antenna array

A new architecture for the Van Atta self-steering array is presented. Active antenna techniques are used to realise a compact self-steering array with enhanced retrodirective properties. The experimental performance of the array is demonstrated and a technique is described which compensates for the beam pointing error induced by antenna array element directivity     

System requirements for Ka-band Earth-satellite propagation data

Accurate estimates of the propagation impairments that affect link quality and availability and determine signal interference fields are essential for the reliable design of telecommunication systems and the efficient use of the electromagnetic spectrum. Recent announcements by commercial entities of their intent to use Ka-band spectrum to supply satellite services have heightened interest in propagation data and models for these frequencies. This paper provides a brief overview of Ka-band Earth-satellite systems and requirements in relation to the need for specific types of propagation data     

Novel NMDA antagonists: replacement of the pyridinium ring of 6,11-ethanobenzo[b]quinolizinium cations with heteroisoquinolinium cations

Replacement of the pyridinium ring of 6,11-ethanobenzo[b]quinolizinium cations with thiazolium (4a and 4b) and N-methylimidazolium (4c and 4d) resulted in equipotent compounds in the [3H]TCP binding assay. The corresponding N-methyl-1,2,4-triazolium analogs were less potent in this assay. The thiazolium derivative 4b, with a Ki = 2.9 nM, is being evaluated as a possible neuroprotective N-methyl-D-aspartic acid (NMDA) antagonist.     

Formula for two-carrier third-order intermodulation distortion in semiconductor laser diodes

Formulas for the two-carrier third-order intermodulation distortion in semiconductor lasers have been reported by many authors. The authors refine the formula further and illustrates the difference in results arising from the refinement, for typical laser parameters.<>